Intimal sarcoma in an ascending aortic Dacron graft mimicking a thrombus
Kayoko Natsume1, Norihiko Shiiya1, Takashi Tsuchida1
1First Department of Surgery, Hamamatsu University School of Medicine, Shizuoka, Japan.
Interactive Cardiovascular and Thoracic Surgery
|August 2, 2019
Summary
A rare intimal sarcoma developed in a Dacron graft within the ascending aorta 17 years after implantation. This malignant tumor caused embolic stroke and was confirmed via immunohistochemistry after initial misdiagnosis as a thrombus.
Area of Science:
- Cardiovascular Surgery
- Surgical Pathology
- Oncology
Background:
- Aortic sarcomas are exceptionally rare vascular tumors.
- Dacron grafts are synthetic materials used in aortic repair.
- Malignant transformation in vascular grafts is an uncommon complication.
Observation:
- A patient presented with cerebral infarctions attributed to embolic stroke.
- Clinical diagnosis suggested a thrombus as the cause of stroke.
- The patient had a history of ascending aortic Dacron graft implantation 17 years prior.
Findings:
- Histopathological re-evaluation of the explanted graft revealed intimal sarcoma.
- Immunohistochemistry confirmed the diagnosis of intimal sarcoma.
- The patient died from widespread metastases 5 months post-surgery.
Implications:
- This case highlights the potential for rare sarcomas to develop in Dacron aortic grafts.
- Early and accurate histopathological diagnosis is crucial for aortic graft complications.
- Long-term surveillance may be warranted for patients with vascular grafts due to rare malignant risks.
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